Background. Sickness certification legislation demands that work ability is
reduced due to disease or injury. Most sickness certificates are issued by
GPs. Assessment of work ability might introduce conflict in the doctor-pat
ient relationship.
Objectives. The aim of this study was to compare the level of work ability
assessments by patients and their GPs in new episodes of sickness certifica
tion, and to explore how medical conditions and work demands are associated
with the assessments.
Methods. Forty nine GPs supplied data about 408 patients certified sick <8
days before questionnaires were filled in. A total of 268 (66%) patients co
mpleted corresponding questionnaires. Patients and GPs independently answer
ed the following question using a five-point scale: "To what degree is your
(the patient's) ability to perform your (his or her) ordinary, remunerativ
e work reduced today?"
Results. Work ability was assessed by patients as very much or much reduced
in 66%, moderately reduced in 23% and not much or hardly reduced at all in
11% of the cases. Corresponding assessments made by GPs were 71, 27 and 2%
. Patients and GPs agreed well on their assessments (+/- 1 answer category)
in 81% (216/266) of the cases. The patients assessed work ability as more
reduced the more stressful or physically strenuous their jobs were, and the
older their GPs were. The GPs assessed work ability as more reduced the mo
re their assessments were based on clinical findings.
Conclusions. The agreement between work ability assessments made by patient
s and GPs was high, despite patients' assessments being associated with wor
k demands and GPs' with medical conditions.